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Posted by star on 2018-07-20 13:49:49 Hits:154
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Natriuretic Peptid, a large family including many members such as ANP, BNP, CNP, DNP, VNP. And BNP is the most important. In view of the important role of BNP in the diagnosis, differential diagnosis and treatment of heart failure, we summarize the common problems of BNP and heart failure.
1. What is NP and BNP?
NP is the short name of Natriuretic Peptide. This is a large family, including ANP, BNP, CNP, DNP, VNP and many other members, and BNP is one of them, which is especially closely related to heart failure. BNP was obtained in 1988 by Japanese scholar Sudoh from Pig Brain, so it was named B type natriuretic peptide.
2. Where is BNP from?
BNP is secreted from ventricle, and cardiomyocytes feel tension and traction, which will increase BNP secretion. Of course, the precursors secreted by BNP were transformed into BNP by some enzymes. It can be seen that the heart is not only the core of the circulatory system, it is also an endocrine organ.
3. What is the relationship between BNP and NT-proBNP?
The initial release of the cardiac muscle cells to the blood was pre natriuretic peptide (Pre-proBNP), which decreased to proBNP, and proBNP was further degraded to BNP and NT-proBNP under the action of the enzyme, and BNP was a bioactive part, and NT-proBNP was only the nitrogen end after shear. Peptide, which is similar to insulin and C peptide.
Insulin has biological activity, but C peptide is only the inactive fragment after shearing. Both insulin and C peptide can be used in the diagnosis and typing of diabetes mellitus. BNP and NT-proBNP can also be used for the diagnosis and severity assessment of heart failure. 
4. The biological activity of BNP?
The biological activity of BNP is mainly reflected in three aspects:1, Diuretic, reduce capacity load. 2, Vasodilatation can reduce blood pressure and increase blood perfusion of kidneys and coronary arteries.3, Inhibition of RAAS and sodium retention.
5. What are the other differences between BNP and NT-proBNP?
Both BNP and NT-proBNP are derived from proBNP, both of which are formed by enzyme degradation, and the molecular weight of BNP is relatively small, 3.5KD, and NT-proBNP molecular weight is relatively large, which is 8.5KD. The half-life of the two is also different. The half-life of BNP is only 20~30 minutes, while NT-proBNP can reach 120 minutes. The concentration of NT-proBNP in the body is higher than that of BNP, so the blood test at the same time shows that the value of BNP is higher, which is why the NT-proBNP value is higher in the diagnosis of heart failure. NT-proBNP is influenced by weight, age and so on, and BNP is relatively small, so in the diagnosis of heart failure, NT-proBNP has different criteria because of the age of the patients. NT-proBNP is scavenged almost all the kidneys in the body, and BNP can be cleared by phagocytic phagocytosis by the receptor of the natriuretic peptide receptor in addition to the renal peptide receptor. BNP and NT-proBNP are all affected by renal dysfunction, and NT-proBNP is more affected.
6. What non heart failure factors can lead to elevated BNP and NT-proBNP?
Heart failure is the most common cause of the rise of BNP and NT-proBNP, but other non - heart failure factors can also lead to a rise in both, including weight, age, pneumonia, respiratory failure, myocardial infarction, and chronic renal dysfunction.
7. How can BNP and NT-proBNP be used for the diagnosis of heart failure?
BNP and heart failure are so closely related that clinical diagnosis has been used for heart failure, here why first discuss how to use BNP and NT-proBNP to exclude heart failure? This is because BNP and NT-proBNP are affected by many factors, the accuracy of heart failure excluded by both is much higher than the accuracy of diagnosis of heart failure.
8. The use of BNP and NT-proBNP in the diagnosis of heart failure?
As NT-proBNP is influenced by age, NT-proBNP has a corresponding diagnostic value for the diagnosis of heart failure due to different age. For acute heart failure, BNP> 300 pg/ml, NT-proBNP > 450 pg/ml (<50 YS), NT-proBNP>900pg/ml (50~70 YS), NT-proBNP> 1800 (> 70). For chronic heart failure, due to many factors, there is no clear boundary value for diagnosis.
9. Is the level of BNP and NT-proBNP related to the severity of heart failure?
The level of BNP and NT-proBNP is related to the severity of heart failure. The higher the level, the more serious the heart failure, and the high level of BNP and NT-proBNP in the treatment, which often suggests poor prognosis.
10. A summary of the clinical application of BNP and NT-proBNP?
(1)Differential diagnosis of dyspnea
(2)Diagnosis of heart failure
(3)Evaluation of prognosis of heart failure
(4)Treatment of heart failure

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